Baby Q's Cellmate

  Quinlan has had a cellmate keeping him company for the last 4 weeks, his stuffed Ducky. Ducky has been very usefully in holding Baby Q's hats when they are not in use. Currently he is sporting a preemie baby blue hat that Quinlan has outgrown, along with a matching hospital bracelet. The nursing staff use Ducky's bracelet when Quinlan is all bundled and they need to scan him to give him meds. This allows them to not disturb Quinlan.

   Ducky looks forward to coming home with Quinlan, but understands that he is not allowed inside the crib at home as having toys in the bed increases the risk of Sudden Infant Death Syndrome (SIDS). Ducky loves Quinlan too much to put his life at risk. Since Quinlan is constantly monitored while in the NICU, Ducky has had the privilege of keeping our little man company here.

Day 27: Getting Ready to Head Home

   Quinlan and his parents are getting ready for his arrival home. This means lots of last minute errands to get the house ready, advice from the NICU nurses regarding care and feeding, and spending time resting up for the big change ahead.

  Quinlan woke up well rested this morning after another night of excellent bottle feeds and was quite awake and interactive when his parents came in this morning. He breast fed at 8 AM, and then dad gave him a bottle at 1030. Mom and dad then walked to Cambridgeside Galleria to take care of any last minute shopping as Quinlan is not allowed in any shopping centers upon discharge. In fact, given his immature immune system, Quinlan is not supposed to visit any indoor crowded areas, interact with any young children, and avoid all sick people. He will also not be put in any child care facility for 6 months to a year. This means we will be looking for someone to care for Quinlan in our home once mom and dad are both working.... any takers?? He is quite cute :)

Oh, forgot to mention that Quinlan is now 5 lb 12 oz. He is no longer "preemie" size and is fitting in the newborn clothes that he received from friends.

dispatches from Q milkdud

Quinlan is doing really well and is on track to come home in two days...on Monday! YAY!

He's taking all his food by mouth, so now has no NG tube, so he's even more photogenic.

Here are some photos of our milkdud!

I call Quinlan a milkdud because he is perpetually enveloped in the sweet smell of breastmilk...it's just lovely to sit and hold him in this satisfied state. And the smell is wonderful.

He also periodically contentedly coos and burps. Yay!

In this picture he is less happy....just about to let out some gas from one end or the other ;-)

Mom's voice and touch are like magic...immediately soothing and reassuring!

"When can I go out to ride bikes with Dad?"

We joke that right after feeding he goes into a milk coma....usually he lets out a few burps or a trickle of milky drool, but he is ever so happy after a breast or bottle feeding session!

Happy Birthday Dad!!

       Quinlan tried hard to be home for dad's birthday, but instead will be a belated present. Dad, this means you can still have a beer or two without worry in celebration.


        Quinlan and mom are sending along happy wishes to dad today!

Day 26: Discharge Planned for Monday

             After receiving all his food last night orally from 6 PM onward, Quinlan has been cleared by the team to plan for discharge home on Monday. They will likely remove the NG-tube later today if he continues taking all his food via breast and bottle. This means the last thing keeping him here is his antibiotics, which he will finish up Monday morning. They will do the car seat test either tomorrow or Sunday (it should be done within 48 hours of discharge), and make sure that his parents have all the education they need to allow for a smooth transition home. There are certain vitamins that mom needs to purchase from CVS in the next few days and a few items that need to be assembled or moved in the house, and then his parents will be set to welcome him home!!                                                                         Mom is trying to extend her leave at work till July, assuming she can work it out with HR. Apparently there may be issues with insurance coverage on an extended leave that need to be addressed.                                     

Day 25: Talks of Discharge

   Dad learned how to give Quinlan a bottle last night. Mom is actually not allowed to give Baby Q a bottle as apparently at this stage it can confuse him as he associates her smell with breast feeding. Currently our little man is doing a fantastic job with feeding, as took a full bottle at his 6 AM feed, full breast and bottle at 9 and 12 and 9. The only reason he did not take full feed by bottle or breast at 3 or 6 is because mom gave him a needed bath and that tuckered him out quite a bit.

  With Q doing so well right now on his feedings, the team anticipates discharge once his antibiotics are finished on Monday. He will have the Car Seat Test today, and will continue to work on feeding while the nurses give mom and dad lots of information about how to care for Quinlan at home.

   Everyone is super excited and mom and dad are running last minute errands to get everything ready for the hopefully arrival of Quinlan Miles to 403 Main St on April 2nd!

Day 24: Superstar Bottle Feeder!

 Quinlan was visited by the Occupational Therapist Julie today to work on bottle feeding. Since he is doing so well with breast feeding, the team thought it would be a good idea to start bottle feeding him his fortified breast milk. The sooner he is taking all food by mouth, the sooner he can go home. Then the transition to just breast feeding will occur at home with the pediatrician's guidance as Quinlan will need to be weighed regularly and weened from fortified milk once he is at an acceptable weight that he can maintain with breast milk alone.

 Here he is with Julie accepting the bottle very well. He surprised her by taking 30 cc of his 41 cc feed, almost 75%, via the bottle. Apparently this is VERY good for a first bottle feed and one of the lactation consultants was there video taping for their instructional video they are putting together. They even got some good shots of his feeding cues.

  Between this and the footage they took of him latching and breast feeding, I have a feeling Quinlan may be the star of this video!

 Quinlan then was propped up afterward on the Boppy has he a some reflux that was causing drops in his O2 saturation. This is a common health problem in preemies and it is beneficial to keep them in a more upright position to decrease the ability of the stomach acid to travel up into the esophagus.

 Here Quinlan is showing you his "milk coma" dazed look. He them happily returned to sleep after this picture was taken.

  The plan is now to breast feed every other feeding when he demonstrates good cuing.  

Tummy Time on the Boppy

In his spare time, Quinlan has decided to work on his head control by doing tummy time on the Boppy

At first he didn't like it and was squirming around a lot, but then settled in and looked super comfortable. So much so, that we hated having to move him in 3 hours to feed. 

The Faces of Quinlan

 Dad took this series of Baby Q a few days ago, and loves the picture of him crying and then being soothed with his binky.




Here he is peacefully sleeping before the diaper change and feeding wearing the lovely orange outfit that the Wilson boys passed down to him and the "Q" hat that mom knit.

And then he shows you how he really feels about being disturbed. We likely were taking his temperature at this time... no, it is not taken rectally but under his armpit. Yet, he hates it just the same. 

Then we give him his binky to calm him down and practice his sucking for when he breast feeds. 

And he returns to his angel like state in a matter of minutes, quickly forgetting that awful thermometer and the mean people who thrust it upon him.

Day 23: An Update on Quinlan's Parents

While we have done a decent job updating everyone on how Quinlan is doing, we have gotten a lot of questions regarding his parents well fare, so we thought a quick update on us might be warranted:

Quinlan's Dad  has returned to his student teaching after spending the first week in the NICU with Quinlan and mom. He was observed by his adviser on Friday when he led the entire day of lessons. He received excellent feedback and is set to complete his student teaching in 3 weeks.

He has been biking in daily after finishing with school to the hospital, and has set the record for time holding Quinlan: 3 hours! Quinlan loves time with dad and completely relaxes and gets some of his best sleep during these marathon holds.

Dad has also been keeping the house clean and doing massive amounts of laundry, so Quinlan and mom have been able to wear nice clean clothes at all times. Thanks dad!

Quinlan's Mom has been on maternity leave since March 5th, so she has been able to spend ample amount of time at the hospital. She has had multiple visitors who have been able to take her out for walks, bring her food, or just be great company. She is thankful that so many friends are available during the day when Quinlan is resting and growing.

She has been spending some nights at home and some at the NICU. With Quinlan's recent illness this past week, mom spent Monday night at the hospital on the futon in Quinlan's room. She also spent last night as the nursing staff has allowed her to attempt breast feeding based on Quinlan's feeding cues, not limited to the 2 times a day we had been. Quinlan eat 25 cc at 9 PM, and 18 cc at 3 AM. He is currently on 41 cc feeds, so that is basically half with breast feeding!

Mom has also been able to bike into the hospital 1 day this week. She biked in Saturday with dad and loved it. Sunday it was a little rainy, and she needed a break, but hopefully she can bike in more this week as it is super convenient and allows her to break a sweat!

Day 22: A Star is Born?

 

Quinlan had a good night and the night nurse reported that he woke up early for his feeds and was intently rooting and giving feeding cues. The NICU is formalizing their feeding program to respond more to infant cuing rather than sticking to a time schedule. Since Quinlan is transitioning to oral feeds, the nursing staff was hoping to have mom more available for night feeding or permission to try him on a bottle. As both mom and dad would prefer he breast feed, mom will be spending the night again to be available for any and all feedings. 

Also, the lactation consultant has asked to video tape a breast feeding session to use for an educational video they are doing to formalize the infant cuing feeding program. The plan is to film us today at 3pm.... Quinlan will be starting his film career early!

Day 21: Big Boy Bed

 

Quinlan has progressed by leaps and bounds today. He was able to get a little less than half his feeding from the breast this morning, 16 cc, and another 6 cc in the afternoon. He has also been able to regulate his temperature well and was moved from the isolette to a crib!

Here he is with dad after feeding in the morning. They are both quite joyful about all the progress made. At the current rate, if Quinlan continues to progress with feeding, he may be home by April 3rd. A belated birthday present for dad.

Day 20: Hitting the 5 lb Mark!

  Quinlan's parents apologize for missing the post yesterday, but yesterday was a busy day! Mom's work colleagues threw her a baby shower during lunch and Quinlan has some cute new outfits and money to spend at Babies R Us for preemie diapers and formula. Quinlan will be needing his breast milk fortified when he leaves to continue good weight gain and apparently we do that with formula we can buy at the store.
  Quinlan also had 2 breast feeding sessions that went really well, and we will start weighing him before and after feeds tomorrow. The nurses weigh him before and after feeding on the baby scale to determine how many cc's he ingested. They then adjust his food accordingly through the NG-tube so he stays on the same calorie diet, and the remove the NG tube when he is up to full feeds orally.
  Quinlan woke up this AM rooting and ready to feed, and by the end of the day had gained 2 more ounces reaching 5 lb total. Keep in up Little Man!

  Also of note today, the surgical team is no longer following him as his cellulitis is resolving well. The Infectious Disease team has recommended he remain on the antibiotics for another 5-9 days. This means the earliest Baby Q will come home is Monday April 2nd. 

Day 19: Feeling Better and Starting to Breastfeed!

Today, Quinlan woke up full of energy and feeling well. Unfortunately he had a lot of visits from doctors in the morning, so he was unable to spend time with mom or dad till after lunch. The surgical team rounded on him first (no, our Little Man is not having surgery. Apparently the team asked for both a surgical and infectious disease consult when they first noticed the cellulitis that developed under his diaper) followed by the NICU team.

Quinlan was taken off the caffeine and upped to full feeds (his prior level of food intake, without the calorie fortification he was receiving). He was also cleared to attempt breast feeding, and a plan was made with nurse Jen to try it during one of his scheduled feeds today.

This plan got delayed as the team decided to try again to insert a PICC line to administer his IV antibiotics, which the team was now saying he needed for 6-10 more days. This took up most of the morning and then our Little Man was too tired to try and breast feed until the 3pm feeding. When we tried initially he was having trouble keeping the latch, so the lactation consultant decided to try a nipple shield with good results. We are unsure how much milk he ingested, as we did not weigh him before and after, but good swallow sounds were heard. He was so exhausted afterward that he feel right asleep.

We will try again tomorrow and after a few good sessions they will start him on a bottle feed with fortified breast milk.

This is such a good step as Quinlan needs to be able to ingest all food orally as a prerequisite to going home.

Day 18: Prince Quinlan Improving by Leaps and Bounds!

Prince Quinlan has been responding super well to the antibiotics...He's pretty much back to his old antics of wriggling out of clothes, peeing all over and being super cute. The redness and irritation around his groin area turned out to be cellulitis, which has already been improving a lot! yay!

Although he is improving tremendously, he will be on antibiotics for at least another two weeks, so the team wants to give him a more serious IV line, called a PICC line. They couldn't find a good vein today, so will try tomorrow.

We've all been jamming to Guns N Roses Rockabye versions...they dont seem to translate to glockenspiel as well as metallica...It's true we're just biding our time til Q is grooving to deep, bassy technohouse though! Q heard a lot of techno in the womb, so it's just like going home!

Dad added this picture because it's cute, like Quinlan and we have already promised to take him to the Pacific Ocean for some surfing with mom! YES! YES! Dad will sip coconuts while they surf!

Midday Update

Quinlan developed a redness around his groin region that has some swelling. The team has ordered an ultrasound to rule out any urological issues internally, results pending. However, Quinlan successfully peed all over the bed right after this test indicating that that system is working. They are also checking his reproductive system as well. Fingers crossed that all is well.

We are currently trying him off the CPAP as he has been more alert, has been opening his eyes, and really sucking on his pacifier. Hopefully this trial goes well and we can get off the CPAP machine he hates so much.

Day 17: Improving on Antibiotics

The team is still waiting on the blood and urine cultures to come back from the lab, but Quinlan is improving on the antibiotics that he was started on yesterday at 1PM. He is still on the CPAP with significant improvement in his breathing pattern, O2 saturation, and alertness. In fact, they have begun him on feeds again at a lower dose to supplement the IV fluids and the nurse will continue to progress him as he tolerates. He is peacefully resting and trying to fight off whatever it is he contracted.

 This is apparently common in preemies, and the team anticipates resolution in a couple of days. The important thing is that he improved overnight and he will get a change in antibiotics once the cultures indicate exactly what they are fighting to help him improve quicker. Quinlan has continued to be more alert and interactive this morning. He has even resumed sucking on his binky prior to his normal feeding times, which is a good sign, especially since he was set to start breast feeding before this illness occurred and will hopefully progress back to that point by the end of the week.

 Quinlan is a strong little man and fighter with a lot of supporters, so we anticipate this bump in the road will not set him back too much.

Thank you for all your support! We will keep you posted on his progress.

Day 16: Minor Setback, Back on CPAP

  At the 9 AM feed this morning, Quinlan was hard to arouse and was less interactive. The nurse decided to ask the team about putting him back on caffeine as perhaps the lack of stimulant was keeping Quinlan in a somnolent state. He was also having increased periods of apnea. The team put him back on caffeine with no change. They then worked him up for sepsis. These labs will take a couple of days to culture prior to having results. In the meantime, Quinlan has been started on IV antibiotics.

  By noontime, the apnea had worsened with increasing time spent at lower O2 saturation levels. At this point, the team decided to put Quinlan back on CPAP to help with his breathing. He has responded well to this, with less episodes of apnea, and is more alert than before. The team will keep him on antibiotics for 2 days waiting for the results of the lab cultures, and on CPAP as long as his oxygen levels are still occasionally dipping low.
  We are sending him strong thoughts and will keep you updated on his progress. 

Day 15: Look Ma, No Lid!

Quinlan is now regulating his own temperature and is in open air. In order to make the transition successfully, he was dressed in a long sleeved and footed outfit, swaddled and placed under the mint green blanket knit by volunteers. He is also sporting the "Q" hat knit by his mom.

Dad has now requested a matching "B" hat so mom might start that project tomorrow. Mom might also knit some preemie hats while she is here to donate to the NICU as a thank you. Although, there aren't enough hats to show her appreciation.

A Visit from Grammy

With dad out of town this weekend, Grammy came up to help out and to meet her 1st grandson. She kept mom company in the NICU and washed all the onesies that Quinlan has proudly peed on so far. She also cleaned the house, although there was not as much to do as dad has been great about keeping the house "Quinlan ready."

 The sheets are now on the crib, the co-sleeper is being set up, and the house is ready to welcome our little man when he is ready to join us. His temperature was high this AM when we came in (100.1) meaning Quinlan is doing a better job keeping himself warm - progress towards his discharge goals!

Day 14: Sleeping and Growing

 Today Quinlan slept and slept. Whether it was with his arms over his head lying in bed or on mom's boob, Quinlan slept soundly. He even slept through a couple of his 3 hour checks, where the nurse just hooked up the feeding to his NG tube while he snoozed.

 All this sleeping is good, as it allows Quinlan to keep growing and saving up all the calories he used to use up fighting with the CPAP machine, or pulling down his blindfold when he was under the bilirubin lights.

 At the end of the day he weighed in at 4 lbs, 10 oz. So, a nice good day of rest pays off.

Keep growing little man!

Day 13: Up another Ounce!

Quinlan has now consistently gained weight the past few days and is 4 lbs, 9 oz. Up 5 oz from his birth weight. This extra weight will help him regulate his temperature (a graduation requirement). He is still working on suckling and the pacifier is helping to work the muscles he needs. He now latches and suckles for 1 minute periods, requiring a lot of rest in between, but he is starting to get the hang of it. He is also alerting us to when he is hungry or needs to be changed, and wakes up to interact with us during feeding/changing times.

All great signs, keep up the good work Quinlan!

Day 12: Growth Spurt

  Quinlan's mom and dad had a team meeting today with the attending, resident, NP and RN. The team gave a good overview of what Quinlan ha accomplished so far and discussed the road map for the journey forward.
  Currently the plan is to continue to gain weight, to up his calories with increasing body mass, and to begin to introduce him to breast feeding by gradually increasing time suckling trying to achieve 10-15 minutes of continuous suckling with good latching prior to attempting to feed solely from the breast. This usually happens gradually and we have to follow Quinlan's lead.
  Earlier this AM, Quinlan latched with mom and was able to suckle for 1/2 minute prior to getting tuckered out. He did this on and off for about 10 minutes. He also began rooting on dad and was surprised to find no breast. That is OK, as he was able to work on his suckling skills using he new green binky. The green is an upgrade from the purple, is bigger in size, and more similar to mom's nipple size. Dad was able to hold it up for him and Quinlan was very enthusiastic about his sucking on it.

  At the  evening weigh in, Quinlan was up 3 oz and was bumped up to a larger feeding dose of mom's milk: 36 mL up from 34 mL. We hope this helps Quinlan continue to grow, while we try some more non-nutritive suckling over the weekend. Current weight is 4 lb, 8 oz. Up 4 oz from his birth weight! Grow Quinlan, grow!